IMH Topic 1: The historical context of mental health

Question 1

aminism

Answer 1

a supernatural explanation

• belief that everyone and everything has a soul and that evil spirits have taken possession of an individual and controlled their behaviour.
• ppl could be possessed by different kinds of spirits e.g. ancestors, animals, gods - enter through their own cunning - magical powers or lack of faith
• some skulls of paleolithic cave dwellers had holes (trepanes), which were chipped out by stone instruments.
• thought that trepanning was performed to provide the demon or evil spirit with an exit from the skull

Question 2

humourism

Answer 2

a somatogenic explanation

• Hippocrates first identified mental illness as a scientific phenomenon.
• thought madness resulted from an imbalance of the four humours
• four humours: blood, phlegm, yellow bile, black bile
• behavioural or personaility issue believed to be caused by an excess or lack of each of the humours
• this would determine treatment given to try to realign the levels of each humour to restore balance and therefore mental health

For example, depression was thought to be a result of excess black bile, and therefore diets, laxatives, bloodlettings would rebalance this excess.

Question 3

animalism

Answer 3

based on a somatogenic explanation

• in 18th century, the main view was to treat the mentally ill like animals
• believed that the madness had resulted from animalism - person lost the capacity of reason - what distinguished them from animals
• treatment was to restore reason through fear
• person would be kept locked up, chained and possibly whipped
• other treatments such as bleeding, blistering, making them sick and drugs were given with the belief that the insane didn’t have sensitivities of human beings

Question 4

evaluate the historical views in relation to individual/situational debate

Answer 4

individual:
differences in symptoms

situational:
the environment they were in, the treatment they were given could’ve made them worse - no beds, fleas when locked up

Question 5

four ways of defining abnormality

Answer 5

statistical infrequency
failure to function adequately
deviation from social norms
deviation from ideal mental health

Question 6

outline statistical infrequency

Answer 6

behaviour is abnormal if it falls outside of the norm

e. g. the avg IQ is 100, those with very high or very low IQs would be considered abnormal
3. 45% of population with schizophrenia - relatively rare so considered abnormal

Question 7

problems with statistical infrequency

Answer 7

numerical data can be falsified

to be abnormal doesn’t actually mean that there must be a diagnosis of a psychological disorder

Question 8

outline failure to function adequately

Answer 8

when an individual is unable to meet the expectations of how people should live their life and if they cannot live a normal life they are seen as functioning inadequately

Question 9

problems with functioning adequately

Answer 9

subjective - who decides what a normal life is?

the definition doesn’t confer the label of mental illness on that person

Question 10

outline deviation from social norms

Answer 10

expected or approved way of behaving
abnormal behaviour may be seen as that which deviates from social norms
may indicate the presence of a psychological disorder

Question 11

problems with deviation from social norms

Answer 11

If someone doesn’t follow a society’s norms, it doesn’t necessarily indicate a psychological disorder

Question 12

outline deviation from ideal mental health

Answer 12

ideal mental health could be: feeling positive about yourself, act independently, positive social interactions, accurate perception of reality and coping with demands of reality.

may be abnormal if they display one of the following: suffering, maladaptiveness, unconventional behaviour, unpredictablility/loss of control, observer discomfort etc

Question 13

problems with deviation from ideal mental health

Answer 13

some of the criteria could be hard to quantify

Question 14

6 points about DSM

Answer 14

• First published in 1952
• It’s on the fifth edition (DSM-5)
• 22 categories of mental disorder
• It begins with diagnosis from developmental processes that manifest early in life (e.g. neurodevelopmental and schizophrenia spectrum etc)
• Then followed by diagnosis that manifest in adolescence and young adulthood (e.g. bipolar, depressive and anxiety disorders)
• Ends with diagnosis relevant to adulthood and later life (e.g. neurocognitive disorders)

Question 15

usefulness of defining abnormality

Answer 15

only useful if ways of defining are accurate - then treatment can be given

not useful if way of defining is subjective - ppl could be considered abnormal when they are not

Question 16

usefulness of categorising disorders

Answer 16

categorising by the DSM is useful because it allows psychiatrists to prescribe treatment for that condition

less useful as it gives patient a label which can potentially have a negative impact

Question 17

ethnocentrism of defining abnormality

Answer 17

what is abnormal in one ‘culture’ might be ‘normal’ in another culture
so it is problematic to define abnormality in a way that applies to more than one culture

Question 18

ethnocentrism of categorising disorders

Answer 18

some disorders are not recognised in some cultures

so by having different manuals in Europe, China and the USA countries can include conditions that are culture specific

Question 19

ethnocentrism of rosenhan’s study

Answer 19

was ethnocentric as only carried out in America. Mental health seen differently in different cultures

Question 20

usefulness of rosenhan’s study

Answer 20

very useful as lots of things changed in terms of diagnosis in the states, the DSM was re-written

Question 21

individual explanations of rosenhan’s study

Answer 21

individual differences in people’s symptoms and how they cope with them
individual differences in medical staff as not all ignored patients

Question 22

situational explanations of rosenhan’s study

Answer 22

changes in resources, low staff - not being able to spend time with the patients

Question 23

what is the affective disorder

Answer 23

depression

Question 24

characteristics of an affective disorder

Answer 24

5 or more symptoms present during the same two-week period including either symptom 1 or 2

1 - depressed mood most of the day, nearly every day

2 - markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day.

3 - body weight loss of more than 5% not due to diet or change to appetite.

4 - insomnia or excessive sleep nearly every day

5 - restlessness or less activity nearly every day

Question 25

what is the psychotic disorder

Answer 25

schizophrenia

Question 26

charateristics of a psychotic disorder

Answer 26

two or more of the following in one month; at least one must be symptom 1,2,3. Disturbance should persist for 6 months

1 - delusions
2 - hallucinations
3 - disorganised speech
4 - grossly disorganised or catatonic behaviour
5 - negative symptoms such as diminished emotional expression

Question 27

what is the anxiety disorder

Answer 27

phobias

Question 28

characteristics of an anxiety disorder

Answer 28

Classified as specific phobias, agoraphobia and social phobia.

a phobia is an intense, severe and irrational fear that produces a physiological response. will go to extreme lengths to avoid feared item/event and will have a significant impact on their life

Question 29

continued characteristics of an anxiety disorder

agorophobia

Answer 29

marked fear or anxiety about two or more of these:

• using public transport
• being in open spaces
• being in enclosed spaces
• standing in line or in a crowd
• being outside of the home alone

These situations almost always provoke an anxiety attack, and the situations are actively avoided or require a companion.
The fear is out of proportion to the danger even if another disorder might induce anxiety.
The fear/avoidance persists for more than 6 months and causes significant distress and impairment of normal functioning

Question 30

how are characteristics of disorders socially sensitive

Answer 30

a patient may be judged/treated differenlty with a label

Question 31

ethnocentrism of characteristics of disorders

Answer 31

different manuals/different cultures - same symptoms might lead to different diagnosis
some conditions not recognised by some cultures

Question 32

usefulness of characteristics of disorders

Answer 32

useful to diagnose if appropriate treatment is then given

Question 33

5 things each disorder in the DSM-5 has info on

Answer 33

gender-related diagnostic issues 
culture-related diagnostic issues
co-morbidity
prevalence
diagnostic criteria

Question 34

gender-related diagnostic issues

Answer 34

(e.g. “key features of hoarding disorder are generally comparable in males and females, but females tend to display more excessive acquisition, particularly excessive buying, than do males.”)

Question 35

culture-related diagnostic issues

Answer 35

(“In some populations, the eating of Earth or other unseenly non-nutritive substances is believed to be of spiritual, medicinal, or other social value, or maybe a culturally supported or socially normative practice. Such behavior does not warrant a diagnosis of pica.”)

Question 36

co-morbidity

Answer 36

In recognition of the fact that patients often experience more than one disorder at once, DSM-5 includes information on disorders that often co-occur together (e.g. “That appears to be a high co-occurrence of substance use disorders, gambling disorder, depressive and bipolar disorders, and other disruptive impulse control and conduct disorders with pyromania.”)

Question 37

prevalence

Answer 37

(e.g. “The presidents of any recess is 5% to 10% among 5-year-olds, 3% to 5% among 10-year-olds, and around 1% among individuals 15 years and older.”)

Question 38

diagnostic criteria

Answer 38

the criteria for major depressive episode, schizophrenia and agoraphobia)